Health365 eNews
September 2014 • Volume 4, Issue 10

Flu Shots Available for Fort HealthCare Patients

To help you get through flu season without getting ill, Fort Medical Group primary care clinics are now offering flu shots to existing patients specific to the seasonal variety of flu.


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To help you get through flu season without getting ill, Fort Medical Group primary care clinics are now offering flu shots to existing patients specific to the seasonal variety of flu. Patients are encouraged to call very soon to make an appointment to receive a flu shot, which reserves a dose for them for the season. Flu shot appointments are available at some clinic locations as soon as the end of September, and will be available throughout October.

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Newborns and Jaundice: Fear Not!

Having a new baby is a wonderful, but scary, journey. There can be many bumps in the road and, when you’re a new Mom, they can feel overwhelming. As a Fort HealthCare patient, we work to minimize this by monitoring your baby closely.


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Having a new baby is a wonderful, but scary, journey. There can be many bumps in the road and, when you’re a new Mom, they can feel overwhelming. As a Fort HealthCare patient, we work to minimize this by monitoring your baby closely.

One of the things the staff at Fort HealthCare watches for is jaundice. Often noticed as the yellowing of your infant’s skin, this occurs when there is a build-up of the pigment called bilirubin [Pronounced BILLY-rue-bin] in your infant’s blood. Most babies have jaundice to some extent and this causes no problem, but if the level rises too high it can damage the brain. Because of this, your pediatrician or nurse will check your infant’s bilirubin level 24 hours after birth or if any yellowing is noted. Don’t worry! We will never let it rise to an unhealthy level, and will treat jaundice at fairly low levels to prevent medical problems.

Bilirubin is a pigment in hemoglobin, the oxygen carrying part of red blood cells. Before your baby is born, he or she has extra fetal hemoglobin to grab as much oxygen as it can. However, once your baby is delivered and can breathe air, all of these fetal red blood cells are not needed and your baby starts to break them down. Baby’s liver will help rid the body of this excess by mixing it with bile and depositing it in the intestines to be expelled through bowel movements. In some cases though, the baby is overwhelmed with bilirubin.

Some of the causes of these higher levels are:

  • Prematurity:Babies born before 40 weeks may have immature livers that are unable to efficiently bind the hemoglobin for removal.
  • Difficult deliveries: If your baby’s head is bruised by forceps or a vacuum-assisted delivery, there will be more red blood cells for the liver to get rid of.
  • Incompatible blood types or factors. This can set off an antigen-antibody reaction and the increased break down of red blood cells.
  • Difficulty getting enough food, due to prematurity, illness or difficulty with breastfeeding. Infants in this category may have delayed or decreased stooling. Remember: Bilirubin is deposited in the intestines and your baby removes it through bowel movements.
  • So how do we treat this?

    • Phototherapy. This is a fancy was of saying "light therapy."  By exposing your baby to a specific frequency of light waves, we can break the bilirubin molecule down small enough, that it can pass through the kidneys. Some babies will be sent home with a portable Bili Bed for treatment, others may need to be in the hospital for a short time.
    • Increasing your baby’s oral intake (a.k.a. feedings.)  It is important you feed your infant 8-12 times a day. Breast milk will make your infant stool more often, thereby removing the bilirubin more rapidly. Having a baby with jaundice can be frustrating. You will have to return for frequent weight and bilirubin checks. If your baby needs treatment, he or she will have to stay on a "Bili bed" and cannot be cuddled like you want, but remember, this is short term and we will help you every step of the way.
    • To learn more about lactation or how the Fort HealthCare Great Expectations Birthing Center helps deliver happy, healthy babies, visit FortHealthCare.com/Baby.

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You've found a lump: Now what?

If the thought of finding a lump in your breast scares you, you’re not alone. However, some women are so frightened, they avoid getting mammograms as recommended—the very habit that could save a life if breast cancer develops. If you’re in that group, you’ll be glad to hear that four out of five breast lumps investigated turn out to be noncancerous. So if they’re not cancer, what are they? The most common causes of breast lumps are described below.


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If the thought of finding a lump in your breast scares you, you’re not alone. However, some women are so frightened, they avoid getting mammograms as recommended—the very habit that could save a life if breast cancer develops. If you’re in that group, you’ll be glad to hear that four out of five breast lumps investigated turn out to be noncancerous. So if they’re not cancer, what are they? The most common causes of breast lumps are described below.

  1. Fibrocystic breast changes are the most common cause of benign (noncancerous) breast lumps. Women who have this condition develop one or more lumps that are either solid or fluid-filled. In a small number of cases, the lumps increase in size and tenderness five to seven days before each menstrual period and shrink again when menstruation ends.

    Experts estimate that up to half of all women between ages 35 and 50 develop fibrocystic breast changes. It is so widespread among the premenopausal population, in fact, that some healthcare professionals consider it to be a normal condition rather than an actual disease. Reducing consumption of caffeine may help relieve the symptoms.

    If you have one or more lumps that do not disappear after your period, see your doctor. Although fibrocystic lumps do not pose a threat to your health and are not considered a risk for cancer, they can be difficult to distinguish from malignant breast lumps. As a result, they should always be professionally evaluated.

  2. Fibroadenomas are most common in women under age 30 and are twice as common in African-American women. These smooth, solid masses feel much like marbles and move easily. Most doctors recommend removing them because they do not go away on their own and may continue to grow—particularly during pregnancy and breastfeeding. Another reason for removal: It is the best way to confirm that the lump is indeed a fibroadenoma and not a malignant mass masquerading as one.
  3. Cysts are fluid-filled sacs that tend to get bigger and more sensitive to the touch before a woman’s menstrual period. They can be either soft or firm and almost any size—from a fraction of an inch to nearly the size of a golf ball. They’re typically found in both breasts and appear most often in women between ages 35 and 50. Your doctor may use a thin needle to draw the fluid out of a cyst to collapse it. If the fluid is cloudy or colored, or if the lump turns out to be solid, it may be analyzed further.
  4. Lipomas occur most often in premenopausal women. These painless lumps, composed of fatty tissue, are soft and slow-growing. Like cysts, they move freely and vary in size. Although they are noncancerous, most experts recommend removing a sample of the tissue or the entire lump to make sure it is indeed a lipoma.
  5. Intraductal papillomas are tiny lumps that occur in the milk ducts near the nipple. They usually affect women in their 40s and can cause a watery or bloody discharge from the nipple. As with other benign lumps, intraductal papillomas should be removed to be sure they are noncancerous.
  6. Mastitis is an infection most often experienced by nursing mothers. The breast appears red and feels warm. A sore lump usually is present, as are flu-like symptoms, such as fever and achiness. Applying heat, getting plenty of rest and nursing frequently on the infected side often will clear the infection. However, if fever is still present after 24 hours, seek medical attention. In most cases, antibiotics will heal the infection.
  7. Traumatic fat necrosis occurs occasionally in older women and in women with very large breasts. This condition can result from a bruise or a blow to the breast. The injury causes the fat in the breast to form round, firm lumps, which are sometimes tender.

A final word of caution: If you happen to find a lump, make an appointment with your physician and do not attempt to self-diagnose. There is no substitute for a professional exam by your doctor, and fortunately, four out of five breast lumps turn out to be noncancerous.

If you are due for your mammogram, visit FortHealthCare.com/MammoRequest to request your appointment online.
Curves in Fort Atkinson (121 N. Main Street) hosts a monthly breast cancer support group on the second Tuesday of each month at 6:30 p.m. The next scheduled group is Tuesday, October 9.

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Recognizing Domestic Violence

Domestic violence is behavior someone uses to control a spouse, partner, date, or elderly relative through fear and intimidation. It can involve emotional, sexual, and physical abuse, as well as threats and isolation. In most cases, men are the abusers. According to the National Domestic Violence Hotline, domestic violence affects people of all socioeconomic backgrounds and education levels. It can happen to anyone of any race, age, sexual orientation, religion, or gender. Violence can occur in couples who are married, living together, or dating.


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Domestic violence is behavior someone uses to control a spouse, partner, date, or elderly relative through fear and intimidation. It can involve emotional, sexual, and physical abuse, as well as threats and isolation. In most cases, men are the abusers. According to the National Domestic Violence Hotline, domestic violence affects people of all socioeconomic backgrounds and education levels. It can happen to anyone of any race, age, sexual orientation, religion, or gender. Violence can occur in couples who are married, living together, or dating.

Domestic violence can show itself in the following ways:

  • Physical abuse. The attacks can range from bruising to punching to life-threatening choking or use of weapons. A problem often begins with threats, name-calling, and/or harm to objects or pets, but escalates into more serious attacks.
  • Sexual abuse. A person is forced to have sexual intercourse with the abuser or take part in unwanted sexual activity.
  • Psychological abuse. Psychological violence can include constant verbal abuse, harassment, excessive possessiveness, isolating the victim from friends and family, withholding money, destruction of personal property, and stalking.

Clues to violence

The following signs often appear before abuse occurs and can be a clue to a potential problem:

  • Violent family life. People who grow up in families in which they were abused as children, or in which one parent beat the other, learn that violence is acceptable behavior.
  • Use of force or violence to solve problems. A person who has a criminal record for violence, gets into fights, or likes to act tough is likely to act the same way with his or her partner and children. Warning signs include having a quick temper, overreacting to little problems and frustrations, cruelty to animals, destroying or damaging objects you value, and punching walls or throwing things when upset.
  • Alcohol or drug abuse. Be alert to drinking or drug problems, particularly if the person refuses to admit a problem and get help.
  • Jealousy. The person keeps tabs on you and wants to know where you are at all times, or wants you to spend most of your time with him or her. The person makes it difficult for you to find or keep a job or go to school.
  • Access to guns or other weapons. The person may threaten to use a weapon against you.
  • Expecting you to follow his or her orders or advice. The person becomes angry if you don’t fulfill his or her wishes or if you can’t anticipate his or her wants. The person withholds money from you when you need it.
  • Extreme emotional highs and lows. The person can be extremely kind one day and extremely cruel the next.
  • You fear his or her anger. You change your behavior because you are afraid of the consequences of a fight.
  • Rough treatment. The person has used physical force trying to get you to do something you don’t want to do, or threatens you or your children.
  • Blocking aid. The person may have prevented you from calling for help or seeking medical attention.

If someone you are with exhibits these behaviors, contact an abuse counselor or another therapist with Fort HealthCare’s Behavioral Health or People Against Domestic & Sexual Abuse (PADA). If you’re in danger, call 911.

Experts say that abusers don’t fit a particular character type. They may appear charming or they may seem to be angry. What is common among abusers are the signs listed above.

People Against Domestic & Sexual Abuse (PADA) is partnering with Fort HealthCare for two showings of “Telling Amy’s Story,” a documentary telling the story of Amy Homan-McGee, a 33-year-old mother of two who was killed by her husband in 2001. She had decided to leave an abusive marriage, and while Amy’s four-year-old and seven-month-old sons waited in the car with her mother, she was fatally shot in the head by her husband.

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Biking Your Way to Better Health

Riding a bicycle can be an excellent fitness activity. Cycling is also a good way to cross-train, because it puts much less stress on your joints, knees, and hips than running or walking. But getting a good workout on a bike isn’t always easy because you have more time to recover—or to just coast.

With this in mind, here’s how to get the most out of your ride, whether you’re cycling on vacation, around your neighborhood, or to and from work.


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Riding a bicycle can be an excellent fitness activity. Cycling is also a good way to cross-train, because it puts much less stress on your joints, knees, and hips than running or walking. But getting a good workout on a bike isn’t always easy because you have more time to recover—or to just coast.

With this in mind, here’s how to get the most out of your ride, whether you’re cycling on vacation, around your neighborhood, or to and from work.

Size up your bike
Your bike should be sized according to your body proportions, advises the International Bicycle Fund (IBF). You can’t change a bike’s frame size, so go to a bike dealer who can fit you properly. To choose a bike with the correct frame size, the bicyclist straddles the top tube, stands with both feet flat on the ground, and checks clearance between the top tube and his or her crotch. Recommended clearance depends on the type of riding you will be doing—1 to 2 inches for road riding and double that for off-road riding. Sizing may vary by brand and may be different from bicycle to bicycle.

Seat height also is important. To position your seat at the proper level, sit comfortably on the saddle and fully extend your right leg with your right heel resting on the pedal in the 6 o’clock position. Sit squarely on the seat with your hands on the handlebars.

If your seat is at the correct height, you’ll have a slight bend at the knee (the knee should be bent at an angle of 25 to 30 degrees). For the most comfort, the seat should be level or tilted slightly downward.

Use your gears
Most all-terrain bikes have 15 to 21 gears. To get a good workout, learn to use all of them, the IBF says. In general, gear down when you’re riding into the wind or uphill; gear up when riding with the wind or downhill. The gears should be used to maintain a steady cadence whether going uphill or down, into the wind, or with the wind at your back.

Ideally, you should consistently ride in a gear that allows you to maintain your target heart rate—50 to 70 percent of your maximum heart rate. Your target heart rate is the range at which sustained physical activity—running, cycling, swimming laps, or any other aerobic exercise—is considered safe and effective, experts at the Centers for Disease Control and Prevention say. You can calculate your maximum heart rate by subtracting your age from 220. Multiply this figure by 0.50 and 0.70 to get your target heart rate range. The more fit you are, the higher the percentage can go. For a precise measurement as you exercise, consider using a heart-rate monitor.

Get in bike shape
Every time you ride, practice these principles to ensure a safe workout: Don’t start off intensely. Instead, gradually elevate your heart rate by warming up for the first five to 10 minutes of your ride by pedaling slowly and riding on flat ground. Otherwise, soreness is apt to set in and you increase your risk of a chronic injury, such as tendonitis. At the end of your ride, cool down for five minutes by gearing down and pedaling more slowly.

Cycle sensibly
Always wear a bicycle helmet and, if you cycle often, consider wearing padded cycling shorts to increase your comfort, the IBF says. Padded gloves can reduce the pressure on your hands. It’s also wise to keep a water bottle handy and take a sip every 15 minutes.

Avoid riding on heavily trafficked streets. When you’re on the road, signal to drivers when you are going to make a turn. Ride on the right side of the road, in the same direction as traffic. Overall, follow commonsense safety rules and ride only in areas where you feel comfortable and safe.

Join us on Saturday, October 20 for the Bike for Mike event at Jones Park in Fort Atkinson. The event is in honor of Mike Wallace, Fort HealthCare president & CEO who was recently informed his T-cell lymphoma has returned, but is not widespread. Cyclists may choose from 50, 30, or 15 mile marked routes. Runners and walkers may also participate and select a distance of their choice. Proceeds will be given to Tomorrow’s Hope, whose mission is to foster health-related research and education, and support activities that have a direct impact on individuals in the area touched by Alzheimer’s, cancer, diabetes, heart disease, seizure disorder and other life-limiting illnesses. Register today!

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8 Great Reasons to Choose Tap Water Over Bottled Water

  1. About 50% of bottled water is filtered tap water, including Aquafina & Dasani brands.
  2. Tap water is practically free. Even if you filter it, you’ll save a bundle.
  3. While bottled water is generally safe, it’s actually less regulated by the Environmental Protection Agency than municipal water supplies.

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  1. About 50% of bottled water is filtered tap water, including Aquafina & Dasani brands.
  2. Tap water is practically free. Even if you filter it, you’ll save a bundle.
  3. While bottled water is generally safe, it’s actually less regulated by the Environmental Protection Agency than municipal water supplies.
  4. Municipal water supplies are tested must report water quality test results annually to the public. You can find a report on your municipal water supply or see the City of Fort Atkinson’s most recently available water quality report.
  5. Contamination test kits for your private well can be purchased online for less than $20. To find out what contaminants to test for, or for a list of local labs, contact the Wisconsin Department of Natural Resources.
  6. Tap water is (usually) fluoridated which has been shown to prevent tooth decay.
  7. 17 million barrels of oil are used each year to produce water bottles.
  8. Consumers deposit only about 27% of their plastic bottles in recycling bins.
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As Prescribed
Looking for timely and accurate health and wellness information from the Fort HealthCare clinicians you know and love? Visit FortHealthCare.com/Blog for updates on women's health, nutrition, skin care, foot pain and many other health topics.

A pain in the foot: Diabetic Foot Ulcers

Fall can be an unwelcome time of year if you have diabetes. Cool evening walks and hiking through those crunchy, fallen leaves aren’t as appealing when you have a foot ulcer. However, following a few simple tips you can prevent a wound from developing or can help it to heal.


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News

Fort HealthCare New Clinic and New Providers

Fort HealthCare opened a new primary care clinic, Fort HealthCare Integrated Family Care, on September 10. The clinic is temporarily located at 426 McMillen Street in Fort Atkinson (the location that formerly housed Fort HealthCare Surgical Associates). In spring 2013, the new practice will move into its permanent location at 1520 Madison Avenue, in the building that currently houses the Goodwill Store and is adjacent to Fort HealthCare Orthopaedic Associates and the Therapy & Sport Center.


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Fort HealthCare Jefferson Clinic Construction Completed

The newly remodeled Fort HealthCare Jefferson clinic opened in August at its permanent location, 840 West Racine Street in Jefferson. The new clinic is a modern space capable of supporting up to three full time providers practicing at the same time and has a procedure room, new imaging equipment and a small lab area on-site for extra convenience. The clinic’s construction was managed by Stevens Construction Corp., which uses a variety of subcontractors that are specialized in certain areas. Every effort was made to use local vendors and contractors when possible.


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Rock the Walk 2012 Encourages Local Residents and Workers to "Get Their Steps"

Individuals looking for a way to begin an exercise program or change their current program are invited to join the Fort HealthCare Rock the Walk 2012 Step Challenge. Rock the Walk 2012 is a six-week challenge with weekly prizes, designed to increase the current activity level of participants. Each week, step goals and prize values increase to keep players motivated and engaged. For those who prefer activities other than walking, conversion charts will help calculate the equivalent number of steps for whatever form of exercise completed.


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HIMSS Analytics Recognizes Fort HealthCare with Stage 7 Award

The Healthcare Information and Management Systems Society (HIMSS) recently notified Fort HealthCare that the recent electronic medical record (EMR) initiative at Fort Memorial Hospital and Fort HealthCare clinics has resulted in a HIMSS Analytics Stage 7 Award, signifying attainment of the highest level on the Electronic Medical Records Adoption Model. The HIMSS Analytics Stage 7 award honors hospitals operating in a paperless environment and represents those organizations that have achieved best practices in implementing an EMR. Fort HealthCare will be recognized at the 2013 Annual HIMSS Conference & Exhibition in New Orleans, La. on March 3- 7, 2013.


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2012 Love Lights Program to Fund Sexual Assault Nurse Examiner Program

For 28 years, the response from individuals, organizations, clubs and businesses has made the Fort Memorial Hospital Love Light Tree project a successful annual event, exemplifying the spirit of giving. The support given to the project has generated funds to help people of all ages with a variety of healthcare needs. The Love Lights will decorate several evergreen trees on the hospital grounds facing Sherman Avenue beginning in December.


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Healthcare Innovation Grants Provide Funding for Community Wellness Improvement

Every year, the Fort Memorial Hospital Foundation funds projects that will enhance the quality of services offered at Fort HealthCare through the Healthcare Innovation Grant program. The program is open to all Fort HealthCare employees with creative and collaborative projects that can positively impact the health and well-being of members of the community, as stated in the organizational mission statement.


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Fort Memorial Hospital Simulated Learning Lab Receives Local Grants

In a recent communication, Dean Johnson, president of Nasco International, has informed representatives of Fort HealthCare of a $75,000 award earmarked for equipment purchases related to the proposed simulation teaching and training laboratory at Fort Memorial Hospital. The funds will allow Fort HealthCare to create the lab and purchase a variety of whole body adult and infant mannequins capable of responding in real time to certain medications, chest compressions, needle decompression, chest tube placement, and other medical interventions through integrated computer technology. The mannequins will serve as the primary teaching and training tool at the Fort HealthCare Learning Center. The donation is a cash award from The Aristotle Corporation Charitable Gift Trust. In addition, a bequest of $10,000 for the Learning Center has been made by the Kachel Family Foundation. These generous contributions will be supplemented by a $21,000 donation by the Fort Memorial Hospital Foundation using proceeds from the recent Derby Day Gala.


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Upcoming Events
Fort HealthCare is proud to sponsor a number of community events. All year long, you can find a number of health and fitness related events and classes for the whole family. Check out Health365Events.com to find more activities throughout the community.
October 10 Yoga Express
October 15 AHA BLS Recognition Course
October 20 Bike for Mike event
October 20 Free Men's Health Talk
October 23 Sweeteners: Facts and Fallacies
October 26 AHA BLS Renewal Course
October 26 Red Cross Babysitting
October 27 On My Own at Home
October 30 AHA Heartsaver CPR/AED
October 30 Rusty Hinges
October 10 Skinny Arms Express
October 10 Rusty Hinges Water Exercise Class
October 10 Glutes & Abs
October 9 Yoga
October 10 Body Blast
October 9 AHA BLS Renewal Course
October 9 No Nonsense, Low Impact Workout
Recipes

Spanish Tacos

Serves: 4 (2 tacos per serving)
Recipe from the American Heart Association



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Serves: 4 (2 tacos per serving)
Recipe from the American Heart Association

Ingredients
1 1/2 cups low-sodium mixed-vegetable juice
3 medium garlic cloves, minced
1/2 teaspoon ground turmeric
1/4 teaspoon salt
1/4 teaspoon pepper
4 boneless, skinless chicken breast halves (about 4 ounces each), all visible fat discarded, halved lengthwise
8 6-inch yellow corn tortillas
1 medium tomato, seeded and diced
1/2 medium avocado, diced
3 ounces white cheese, such as queso fresco, crumbled

Cooking Instructions
In a medium nonstick skillet, stir together the juice, garlic, turmeric, salt, and pepper. Add the chicken. Cook over medium-high heat for 2 minutes, or until the juice comes to a boil. Reduce the heat and simmer for 10 minutes, or until the chicken is no longer pink in the center, turning over once halfway through.

Remove the skillet from the heat. Let the chicken and juice sit for about 2 minutes, or until the chicken is cool enough to handle. Transfer the chicken to a cutting board. Using two forks, shred the chicken. Return it to the skillet. Bring to a simmer over low heat.

Meanwhile, warm the tortillas using the package directions.

Spoon the chicken down the center of each tortilla. Top with the tomato, avocado, and cheese. Fold the sides of the tortillas over the filling.

Nutritional Analysis Per Serving:
Calories 288
Total Fat 8.0 g
Saturated Fat 2.0 g
Trans Fat 0.0 g
0.0 g
Cholesterol 73 mg
Sodium 360 mg
Carbohydrates 23 g
Fiber 4 g
Sugar 5 g
Protein 32 g

Dietary Exchanges
1 starch, 2 vegetable, 3 1/2 lean meat

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Phone: 920.568.5000 | www.forthealthcare.com